Senile (atonic) entropion

The etiology and surgery of senile entropion are reviewed. Many of the presumptive causes of this clinical entity including the vague neurological etiology which caused it to be labeled "spastic" have been found baseless, and the explanation of the elder Fuchs, later confirmed by Duke-Elder, that the cause of senile entropion is due to degenerative tissue changes has been found to be more logical and more compatible with the anatomic findings. There have always been two methods of surgical repair of senile entropion: (1) unwinding the lid by resection of horizontal strips of skin or skin and muscle, and (2) by resection of vertical spindles and triangles of tissue to tauten the lids horizontally. I prefer the latter technique.